Tim Noakes on Fatigue, Cowardice, Winners and Losers

For the last 40+ years, South African Tim Noakes, M.D., has been among the most iconoclastic of sports scientists. In the 1970s, he and colleagues proved that a veteran marathoner could die from heart disease, refuting the "Bassler hypothesis." They did this with hard evidence: images of the unlucky marathoner's heart.

In the 1980s, while everyone else was hyperventilating over dehydration, Noakes practically invented exercise hyponatremia, i.e., "overdrinking," among endurance athletes. The evidence? Studies of how much runners drank during marathons, particularly their pre-event and post-event weight, and how this affected their plasma sodium levels. Too much drinking lowers sodium levels, and if it goes too far, this can become a life-threatening condition.

For the last decade-plus, Noakes, author of the justly-famous Lore of Running and the soon-to-be-published Waterlogged, has focused his attention on a concept he calls the "central governor." In Noakes view, the central governor, i.e., the brain, is what limits endurance performance.

Take for example the sub-2-hour marathon. We all know that no current marathoner can achieve that mark. But why? For most of the last century, exercise physiologists have given a host of reasons: insufficient leg muscle endurance, too much lactic acid, insufficient vo2 max, insufficient glycogen supply, too much dehydration, and the like. These are all very nice things, because each can be measured.

Noakes believes all these explanations are wrong. He says no one can run a sub-2-hour marathon because, in effect, the brain won't let us. The marathoner hasn't been born yet with a sub-2-hour brain, and the body to back it up.

But now Noakes has a problem. When it came to his heart and hyponatremia findings, he had solid evidence to support his position. But where's the evidence for a central-governor impact on endurance performance? And if a central governor does exist, how do you measure it?

"The Noakes paper has an interesting concept for a role of the brain in fatigue and athletic performance," notes Henriette van Praag, Ph.D., a reviewer of the paper and an neuroscience investigator at the National Institutes of Health. "It lacks a clear structural/physiological basis within the central nervous system. Thus, empirical evidence for the existence of a ‘governor’ remains to be established."

In a wonderful new paper in Frontiers in Physiology, available here, full-text, free, Noakes makes little to no attempt to pin down the central governor with a measuring stick, such as the IQ scores often used for intelligence. He does seem to like something called the TEA (the Task Effort and Awareness scale), which he sees as a counterpart to Gunnar Borg's RPE (Relative Perceived Exertion scale).

But Noakes tells the central-governor story in a narrative form that's almost, well ... almost readable. I'm not saying the paper is easy-going, certainly not for the faint-of-heart. And I'm sure there are vast parts of it that I don't understand—it appears to have about 150 references, many of them from the last year or two of research.

Still, the quotes from great athletes are always entertaining. Roger Bannister says: "The great barrier is the mental hurdle." Former marathon world record holder Derek Clayton says: "The difference between my world record and many world class runners is mental fortitude. I ran believing in mind over matter."

Apparently Noakes does as well. In the provocative last section of his paper, he writes that the "illusionary" symptoms of fatigue are what separates the marathon winner from the runners-up. The first time I read this section, I couldn't help but think about the people with illusionary thoughts who are often locked up in mental wards. Of course, Noakes isn't saying that fast runners are crazy. Only that their thoughts are illusionary in the sense that they "are entirely self-generated by each athlete's brain and so are unique to each individual."

Noakes closes by quoting Vince Lombardi, who said, "Fatigue makes cowards of us all." Noakes believes, however, that Lombardi got things backwards. Noakes writes: "My unproven hypothesis is that in the case of a close finish, physiology does not determine who wins. Rather somewhere in the final section of the race, the brains of the second, and lower placed finishers, accept their respective finishing positions and no longer challenge for a higher finish." The winner's brain simply doesn't give in.

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